Surgical Approach to Bladder Lithiasis

Abstract

Introduction: Bladder stones are characterized by the formation of stones in the bladder, affecting the quality of life with symptoms such as pain and urinary obstruction. Influenced by obstructive, infectious and metabolic factors, its prevalence varies with geography and socioeconomic conditions. Advances in surgical techniques motivated this study to review and evaluate the effectiveness of minimally invasive surgical approaches. Objective: The study aims to review and consolidate scientific information on surgical approaches for bladder stones, contributing to the choice of the most appropriate method in each case, with a particular focus on minimally invasive techniques. Methodology: An exploratory literature review was conducted in the PubMed, LILACS, SciELO, MedlinePlus and Google Scholar databases, using DeCS descriptors. The search focused on literature published from 2010 to 2023 in English or Portuguese, with an emphasis on minimally invasive procedures and surgical techniques for the treatment of bladder stones. Studies published outside the period, in other languages, or that were not directly related to the topic were excluded. The final selection included 8 studies for detailed analysis. Results and Discussion: The incidence of bladder stones shows significant variations related to the availability of medical services and regional factors. Transurethral lithotripsy is the preferred technique for smaller stones, while percutaneous lithotripsy is highlighted for larger stones or in unfavorable anatomical conditions. Open surgery is reserved for extreme cases. Success rates are high in general, and recurrence is strongly linked to the presence of predisposing factors such as obstructions and chronic infections. Final Considerations: The choice of surgical procedure should be personalized, considering the patient's clinical and anatomical factors. Transurethral and percutaneous lithotripsy have proven effective, while laparoscopic and robotic techniques represent promising advances. Future studies are essential to improve the efficacy, cost-effectiveness and safety of interventions, ensuring better clinical outcomes and reducing recurrence rates.